Information Collection

UYC Cog Testing and Focus Groups

IC 235431 under ICR 201606-0607-003 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 UYC Cog Testing and Focus Groups	Form and Instructi
1 Focus Group Protocol Attachment II - Focus Group Protocol.docx	Form and Instruction
2 Cognitive Interviewing Protocol Attachment III - Cognitive Interviewing Protocol.docx	Form and Instruction
Main Stage OMB Memo_v2.docx OMB Memo	IC Document
Attachment I - Recruiting Flyers.docx Recruitment Flyers	IC Document
Attachment IV - Consent Form.docx Consent Form	IC Document
Attachment V - Telephone Screener.docx Screener	IC Document

IC Title:

UYC Cog Testing and Focus Groups

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Focus Group Protocol	Attachment II - Focus Group Protocol.docx		No		Fillable Fileable
Form and Instruction	2	Cognitive Interviewing Protocol	Attachment III - Cognitive Interviewing Protocol.docx		No		Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 210

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	210	210
Annual IC Time Burden (Hours)	480	480
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Memo	Main Stage OMB Memo_v2.docx	05/07/2019
Recruitment Flyers	Attachment I - Recruiting Flyers.docx	03/20/2019
Consent Form	Attachment IV - Consent Form.docx	03/20/2019
Screener	Attachment V - Telephone Screener.docx	03/20/2019

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.